Eligibility Response Detail

CIN: AB12345C

Date of Service: July 1, 2026

Submitted: July 26, 2026 1:16 PM

Payload ID: a27f55e2-19bf-4058-b344-d5f81974d379

Response Type: X12 271

Response Status: Rejected

Member Found: Yes

Coverage: — — —

Plan: —

MCO: —

Received: July 26, 2026 1:16 PM

Parser Version: 1.0

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260726*1716*|*00501*086213473*1*P*:~GS*HS*00ND*EMEDNYREL*20260726*1716*213473*X*005010X279A1~ST*270*3473*005010X279A1~BHT*0022*13*202607261716000001*20260726*1716~HL*1**20*1~NM1*PR*2*NYSDOH*****PI*EMEDNY~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~PRV*PE*PXC*251B00000X~HL*3*2*22*0~TRN*1*202607261716000001*00000000ND~NM1*IL*1******MI*AB12345C~EQ*30~DTP*291*D8*20260701~SE*13*3473~GE*1*213473~IEA*1*086213473~

Raw 271 Response

Full screen

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260726*1316*^*00501*269590430*0*P*|~GS*HB*EMEDNYREL*00ND*20260726*131650*269590430*X*005010X279A1~ST*271*269590430*005010X279A1~BHT*0022*11*202607261716000001*20260726*131650~HL*1**20*1~NM1*PR*2*NYSDOH*****FI*141797357~PER*IC*EMEDNY PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~HL*3*2*22*0~TRN*2*202607261716000001*00000000ND~NM1*IL*1******MI*AB12345C~AAA*N**72*C~DTP*472*D8*20260726~SE*13*269590430~GE*1*269590430~IEA*1*269590430~